Changes in End-of-Life Quality in Patients With Terminal Cancer During Their Last 6 Months of Life: A Longitudinal Study.
Chen Hsiu Chen, San Chi Chen, Hsing Jung Lee
PMID 41217413WHAT IT FOUND
Terminal cancer patients reported worse end-of-life quality as death approached, especially symptoms and personal control.
The proportion rating overall end-of-life quality good to almost perfect fell from 68.6% to 34.6% in the last 6 months.
Key findings
01Total end-of-life quality declined significantly during the last 2 months before death compared with 91 to 180 days before death.
02Symptoms and personal control had the lowest initial subdomain score and the most substantial decline in the proportion rated good to almost perfect, from 61.9% to 26.7%.
03Treatment preferences did not significantly change over time.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was a convenience sample from two medical centers in northern Taiwan, so the findings may not apply to other countries or settings. Only patients with a primary caregiver were included, so patients without caregiver support were not represented. 280 patients were enrolled, but 51 were excluded from the final analysis because they were still alive at the end of the study or had data collected more than 6 months before death. 24.0% of participants were recruited in their last month of life, and 17.5% were assessed only once, which limits tracking of change over time. The quality-of-dying measure was modified for this study, and the authors state that its validity and reliability for terminally ill cancer patients need further validation. The study observed patients over time and did not test an intervention, so it cannot show what caused the decline or what would improve it.
Declared interests
The supplied text names the National Science and Technology Council as the funder.
The easy way to misread this
Do not conclude that end-of-life care caused the decline or that a specific intervention would improve it. This was an observational follow-up study without a tested treatment, and worsening may reflect dying, disease progression, or other unmeasured factors.